Day 1.5

The first day is always a bit of a haze, so we can count the first day as 0.5:) The teams are arriving, from all areas of my life, and the US. Santa Barbara, Memphis, Chicago, Abingdon…as always, it is a grand reunion, and such a joy! We have thus far converted an idle shell of a hospital to a facility with 5 operating room beds, a recovery room complete with critical care monitoring, a preoperative holding area, a pharmacy and inpatient medical/surgical ward. With an early core of volunteers, we are now ready to receive the big mission family!!!!

As  always, our hosts are gracious, the local team of volunteers excited and hard working, ready to serve their own. Seeing the Philippines through the eyes of friends who have never been, and through friends who call this part of the world home can be illuminating. It is hard not to learn a lesson from even one day of carefully sorting through precious medications so as not to lose one bottle, or one syringe to waste. We do much with little, serve many with a few. Our “few” is the largest ever, with 41 volunteers on this mission! We look forward to serving many, however, and many hands make light work.

I am so excited for our team, to experience this work in a personal and professional way. I am excited for myself and my family, to continue to grow with and through each other in this work. We are so blessed. And we are so grateful to be here.

Please pray for us, send good vibes, think good thoughts, and maybe check in every once in a while.

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Day 3 Iligan Mission

img_2182Day 3 and 31 cases in!

We have had plenty of large difficult procedures, all life changing for both the patients, as well as the team. The stories from the families include: a young girl with an encephalocele (this is a birth defect where a person is born with a hole in her skull that allows part of the brain to protrude). She was unable to be cared for by her biological mother, abandoned and was then rescued and raised by her cousin.

Not all of our patients have such dramatic and tragic stories. Most of our folks have quite simply had to make life choices that impeded their ability to attain surgical care. This means we have patients who have been suffering from various problems for 12-25 years! YEARS! No tragedy, just simple life decisions made on life choices. This is the primary need we are filling. We are caring for people who have had to defer their health care due to life chances and choices. We aim to help them get back on their feet and to they walk of life. So far so good. We pray that we continue to do the work we are called to do, with the quality we aim to provide, and with the compassion and love we are commanded to share.

Mission Iligan Philippines

Working in missions is humbling in so many ways. Just today, we noted on the aspects of daily life that we absolutely take for granted moment to moment. The predictability of presence of things like water, a trash can, an easy restroom to use, and even warm bath water. These things are not absolute givens.

We all take for granted the very things other people consider pure luxury. In life, this may show itself as uncertainty of the time of a meal, the time of a ride home, or maybe even whether or not we will have a meal. When doing surgery in a context different from our daily lives, the little things are all opportunities for stress. They are all variables. Even the person who is responsible for handing you instruments is new and unfamiliar.

All things on mission trips are uncertainties, new experiences, unknowns even. Imagine dancing with a stranger. The first steps or even the first whole dance is a challenge, awkward even, as you struggle to anticipate, or maybe even match your partner’s movements. This is the same in many ways. The anticipation of another’s movements, of their needs, and their thoughts on where we are heading are all real.

In talking with one of our residents today, I asked her what she learned. She learned today that she is not as flexible, or versatile as she thought. She realized that she was much more fixed, and more needy around certain aspects of her work, than anticipated. Such an incredible lesson to learn in the field. There is a reason that fast food chains work. We are all creatures of comfortable habit. Meaning, habits or patterns of behavior, create a façade of familiarity. They create an environment or context with which we are familiar. All of this lowers the levels of stress and anxiety.

The term “preference card” is a misnomer.(A preference card is a wish list of items and supplies that a surgeon puts together for surgical teams to prepare for each surgery.) Many of us might rather call them “absolute or all or nothing cards” because we hold them so close to our minds and hearts. How we work is typically how we were taught, or evolved over time to work. Neither of these things are easily changed. They are kept as a pattern for a reason. We find what works best for us and our patients alike.

This undergirth of stress and unfamiliarity and dare I say instability, is something not altogether different from what people in poverty experience every single day. It has been termed “toxic stress. The uncertainty around finances, food, shelter, safety from violence and maybe even the possibility of employment, all contribute to create a context of multiple stressors for an individual or family. This toxic stress is so powerful that it has been shown to lead to negative health outcomes around infection, hypertension, atherosclerosis and central obesity. Toxic stress in a mother even affects a growing fetus as it is developing in utero.

We reflect on the stress that we experienced today, with a little different set of instruments, with new staff, with unfamiliar operating rooms, beds and equipment, and with patients that look different than our usual Memphians/ Chicagoans/Seattle-ites/Sacramentoans. Now think how this little bit of stress affected how we felt at work today. This work stress is a mere fraction of what our brothers and sisters in poverty experience every single day. These are things we will never understand even just at surface level unless we seek to find out. Maybe this is our lesson of the day: Seek the lessons that teach us to be more sensitive, and increase our ability to recognize, or maybe even anticipate, the stressors the people around us might be experiencing.

Day 1/2: Set-up

So I completely neglected to write about yesterday’s screening clinic!

It felt like Day 2, but it was still Day 1, or Saturday:)

John and I had our pre-surgery GSurg clinic where we saw all of the folks who had been screened for General Surgery, both medically, and socioeconomically. Our partnerships with the wonderful local public health practitioners is clutch. They help us make sure we are serving the need.

A little background here. Negros Occidental, or the Western half of the island that we are on has endemic thyroid disease, primarily due to iodine deficiency. On my last research, as of 1983, over 70% of the 12 year olds in school were severely iodine deficient! This improved in 1998, which were the last stats I found. But the challenge around thyroid goiters remains.

So not surprisingly, many of our patients needed help with their thyroid goiters. These procedures can be super challenging, due to the vascularity (think lots of blood supply, so higher risk of bleeding) and the sheer size of them. Our record last year was a 15 cm thyroid lobe!

The other patients had primarily challenges with hernias. Many of them have been waiting YEARS for help with their challenges. We even had one patient that had seen us on our last mission in 2010. We did a hemithyroidectomy (removed half of her thyroid gland), but the other side enlarged and was starting to give her trouble. Because these tend to be challenging operations, and because she had not yet tried medication, we recommended that over surgery. If she had the operation, she had the risk of being on lifelong medication. And…if it is a decision she has to make, she would choose food and water over medicine, like all of us would.

I had a special moment in my heart honestly, running this clinic with my friend and colleague John ( I know, go ahead, roll your eyes), but it is a super special thing to be able to serve together. Not every day does this happen!!!!:) And to see Amber Rose and Tina working together tho figure out how to make our operating rooms work….and then to see our instruments from our last mission, organized and labeled by a surgeon that came with us last year, Jig Deneve, another fave of mine!

The local staff had to interpret for us as they spoke a completely different dialect from Tagalog, but good news was that with the little courtesy phrases I knew, they were understood as my attempt to show respect. Hoorah!

Remarkably we finished set-up on Saturday afternoon. We opened our blessed MAP International boxes, cleaned our beautiful Scanlan instruments, organized our Santa Barbara surgical supplies, sorted drains and prep from Johnston Memorial Hospital in Abingdon, and distributed our Ethicon sutures between rooms. And of course all of this was shipped with the funds from our GoFundMe campaign supporters. What a family of support we are!

So much to be grateful for. So blessed to have such a tight mission family. You all are with us. 🙂